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General NPI Number Information
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NPI Number | 1316894876
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Entity Type | Individual
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Provider Name | NICOLE ALSTON LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/13/2026
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Last Update Date | 03/13/2026
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Provider Practice Location Address
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Address Line | 217 W BROADWAY UNIT 221
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City | PORT JEFFERSON
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State | NY
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Zip | 11777-1356
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Country | US
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Telephone | 631-410-6505
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Fax |
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Provider Business Mailing Address
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Address Line | 101 PLAZA CTR
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City | SECAUCUS
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State | NJ
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Zip | 07094-3508
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Country | US
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Telephone | 646-722-8675
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 126737
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License Number State | NY
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